自閉スペクトラム症児と家族の食事時間への介入—保護者と共にビデオ分析を実施した事例報告

Mealtime interventions for children with autism spectrum disorders and their families: Case reports utilizing video analysis and collaboration with parents

要旨：自閉スペクトラム症児との食事時間に困難さを持つ家族は多い．今回，2名の自閉スペクトラム症児とその母親を対象に家庭での食事場面をビデオに撮り，それを基に母親と一緒に評価し，目標と具体的対策を検討し実施した．事例1は家庭で食べられる物の種類が増え，事例2は離席の回数が減った．2事例ともに子どもの作業遂行能力が向上し，食事時間の母親の遂行度と満足度も向上した．また，母親が自ら子どもの問題を評価し，対応策を考えるようになっていった．これらの要因は，ビデオを介し家族の文脈を理解したうえで母親と協働ができたこと，協働していく過程で母親自身が問題解決できるようになったことが考えられる．

Many families with children on the autism spectrum have difficulties during mealtime. In this study, we videotaped the mealtimes of two children with autism spectrum disorder and their mothers at home. Problems, goals, and methods to improve mealtimes were discussed with the mothers based on these videotapes. Case 1 increased the variety of foods eaten at home, and Case 2 decreased the number of times they left their seats. In both cases, the children's ability to perform tasks improved, as did the mothers' performance and satisfaction at mealtime. In addition, their mothers were gradually able to evaluate their mealtime problems and to deal with them independently. These results indicate that our collaboration based on videotapes lead their mothers to be able to understand their families' situation and finally solve the problems by themselves.